EDITORIAL

Improving Your Practice Through the FPM Self-Test

As family physicians, we all share certain characteristics, such as a predisposition to focus on the whole person and an ability to handle the vast majority of our patients’ health needs and to help coordinate their care. Beyond those generalities, though, our practices may differ significantly in size, focus, patient population, services offered, financing and many other characteristics. So the question “What makes a high-quality family practice?” may have hundreds of different answers. But the question is important, as are the ones it calls to mind: How good is my own practice? What specifically can I do in my practice to enhance its real and perceived value to patients, families, health systems and the public? What are the essentials of an effective office practice of the 21st century? What should my staff and I be learning and implementing in our practice to get there? Where do we start and what are the priorities?

See your practice in a whole new light

The “Family Practice Management Practice Self-Test” (page 41) is intended to help each of us answer the above questions. The self-test is based on 44 statements that at least arguably describe important elements of optimal family practice. For each of the statements, the self-test asks you to answer for yourself two key questions:

How closely does the statement describe my practice?

How important is this to attain?

This tool is designed for self-assessment. In our opinion, there is no one correct set of answers any more than there is a single optimum way to be a family physician today. Just as many family physicians choose not to do obstetrics, see hospitalized patients or perform sigmoidoscopies, not all will consider it important to purchase a palm-top computer, develop a Web site, keep a registry of all their patients with diabetes or conduct patient satisfaction surveys.

At the same time, this self-test is a statement about the way we at FPM see family medicine evolving in the 21st century. We view the self-test as a natural part of our mission to provide the right tools for today’s family physician and to help our readers acquire the knowledge and skills they need for optimal family practice. The FPM curriculum (the range of subjects we cover) has evolved over the past seven years as we continually scan the ever-changing health system to identify what works, and the subjects covered by the self-test are largely a reflection of that curriculum (see “Tools for Today’s Family Physician: The FPM Curriculum,” January 1999, page 10).

Naturally, then, the self-test reflects what we now think may be the ultimate in family practice. For instance, we believe in the growing importance of improving and documenting our quality of care and in monitoring and enhancing patient relations, and we believe that computers and electronic medical records are becoming an essential part of effective family practice. But we also recognize that we don’t have a special claim to clarity of vision.

If you can’t imagine why the self-test advances such-and-such as important, don’t immediately discount it; after all, it’s likely to be supported by the literature or at least by expert opinion. But at the same time, remember that what you think is important is what will guide you.

Begin to map out your future

The self-test is intended to help you see where you are and where you want to go. At the very least, it should start you thinking about your practice in new ways. And if you send your results to FPM as described in the self-test article, we can also give you an idea of where your practice stands in comparison to other, similar practices. Even better, the version of the self-test that appears on the FPM Web site will calculate the results for you, and it is linked to a variety of past FPM articles and other resources to help you find the tools to get where you want to go. Additionally, your responses to the self-test will help us plan future articles and the continued development of the FPM curriculum to better meet your needs.

With those caveats, please take a few minutes to complete the self-test. We think that you will find it helpful and stimulating. Have fun!

Dr. Rivo, the medical editor of Family Practice Management, is south Florida regional medical director of AvMed Health Plan, a volunteer clinical professor of family medicine at the University of Miami and senior fellow at the Center for the Health Professions at the University of California at San Francisco.